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A systematic analysis of surgical interventions for the airway in the mature unilateral cleft lip nasal deformity: a single case study.

Publication ,  Journal Article
Tillis, RT; Shah, R; Martin, HL; Allori, AC; Marcus, JR; Frank-Ito, DO
Published in: Int J Comput Assist Radiol Surg
January 2022

PURPOSE: Individuals with unilateral cleft lip nasal deformity (uCLND) often require rhinoplasty in adolescence to correct nasal obstruction. The intent of this study is to identify sites of greatest nasal obstruction and evaluate the effects of isolated and combinations of simulated surgical procedures on these sites using computational fluid dynamics (CFD). METHODS: Computed tomography imaging of an adolescent subject with uCLND was converted to an anatomically accurate three-dimensional nasal airway model. Initial analysis was performed to identify anatomic sites of obstruction based on CFD computed resistance values. Virtual surgery procedures corresponding to common uCLND surgical interventions were simulated. Resulting airspace models were then analyzed after conducting airflow and heat transfer simulations. RESULTS: The preoperative model had 21 obstructed sites with a nasal resistance of 0.075 Pa s/mL. Following simulated surgical procedures with functional interventions alone and in combinations, the three virtual surgery models with most improved nasal airflow were inferior turbinate reduction (ITR) with posterior septoplasty (resistance = 0.054 Pa s/ml, reduction in 14 of 21 obstructed sites), ITR with anterior septoplasty (resistance = 0.058 Pa s/ml, reduction in 8 of 21 obstructed sites), and ITR with both anterior and posterior septoplasty (resistance = 0.052 Pa s/ml, reduction in 17 of 21 obstructed sites). CONCLUSION: This study introduces a new technique for analysis of the impact of different simulated surgical interventions on uCLND-induced nasal obstruction. In this subject, simulated septoplasty with ITR on the non-cleft side provided maximal relief of nasal obstruction. The proposed technique can be further studied for possible utility in analyzing potential surgical interventions for optimal relief of nasal obstruction in patients with uCLND.

Duke Scholars

Published In

Int J Comput Assist Radiol Surg

DOI

EISSN

1861-6429

Publication Date

January 2022

Volume

17

Issue

1

Start / End Page

41 / 53

Location

Germany

Related Subject Headings

  • Turbinates
  • Rhinoplasty
  • Nuclear Medicine & Medical Imaging
  • Nasal Septum
  • Nasal Obstruction
  • Humans
  • Cleft Lip
  • Adolescent
  • 4603 Computer vision and multimedia computation
  • 3202 Clinical sciences
 

Citation

APA
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ICMJE
MLA
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Tillis, R. T., Shah, R., Martin, H. L., Allori, A. C., Marcus, J. R., & Frank-Ito, D. O. (2022). A systematic analysis of surgical interventions for the airway in the mature unilateral cleft lip nasal deformity: a single case study. Int J Comput Assist Radiol Surg, 17(1), 41–53. https://doi.org/10.1007/s11548-021-02396-z
Tillis, Rose T., Reanna Shah, Hannah L. Martin, Alexander C. Allori, Jeffrey R. Marcus, and Dennis O. Frank-Ito. “A systematic analysis of surgical interventions for the airway in the mature unilateral cleft lip nasal deformity: a single case study.Int J Comput Assist Radiol Surg 17, no. 1 (January 2022): 41–53. https://doi.org/10.1007/s11548-021-02396-z.
Tillis RT, Shah R, Martin HL, Allori AC, Marcus JR, Frank-Ito DO. A systematic analysis of surgical interventions for the airway in the mature unilateral cleft lip nasal deformity: a single case study. Int J Comput Assist Radiol Surg. 2022 Jan;17(1):41–53.
Tillis, Rose T., et al. “A systematic analysis of surgical interventions for the airway in the mature unilateral cleft lip nasal deformity: a single case study.Int J Comput Assist Radiol Surg, vol. 17, no. 1, Jan. 2022, pp. 41–53. Pubmed, doi:10.1007/s11548-021-02396-z.
Tillis RT, Shah R, Martin HL, Allori AC, Marcus JR, Frank-Ito DO. A systematic analysis of surgical interventions for the airway in the mature unilateral cleft lip nasal deformity: a single case study. Int J Comput Assist Radiol Surg. 2022 Jan;17(1):41–53.
Journal cover image

Published In

Int J Comput Assist Radiol Surg

DOI

EISSN

1861-6429

Publication Date

January 2022

Volume

17

Issue

1

Start / End Page

41 / 53

Location

Germany

Related Subject Headings

  • Turbinates
  • Rhinoplasty
  • Nuclear Medicine & Medical Imaging
  • Nasal Septum
  • Nasal Obstruction
  • Humans
  • Cleft Lip
  • Adolescent
  • 4603 Computer vision and multimedia computation
  • 3202 Clinical sciences